A Single Priming Event Prevents Oral Tolerance to Peanut

This study aims to determine the impact of a single airway exposure to peanut and environmental adjuvants on the development of peanut allergy and oral tolerance in a food allergy mouse model.This study was conducted in male and female mice using a food allergy model.Mice were exposed once to peanut plus adjuvant or placebo through the airway, followed by low-dose oral exposure to peanut. Mice were challenged with a high dose of peanut to assess allergy, and peanut specific IgE and IgG1 were quantified.A single airway coexposure to peanut plus adjuvant, followed by low dose oral peanut exposure, induced peanut-specific IgE and anaphylaxis upon peanut challenge, whereas the mice receiving the placebo airway exposure did not develop allergy. The timing of peanut feeding was crucial, as mice given low dose oral peanut before airway exposure did not develop peanut allergy.This study investigates mechanisms underlying peanut allergy development and potential for early oral introduction to peanut to prevent development of allergy. It underscores the role of nonoral exposure to environmental peanut in allergic sensitization and examines the impact of airway priming on subsequent oral tolerance induction. The findings reveal that even a single airway exposure to peanut and environmental adjuvant is adequate to prime the murine immune system for peanut allergy before oral exposure.Although this study focuses on mouse models, it highlights a critical point for pediatricians: even brief nonoral exposure to peanut may lead to sensitization. The study emphasizes the timing of peanut introduction on sensitization and tolerance, providing another data point supporting early peanut introduction.